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A new published review of standard and investigational treatments for malignant pleural mesothelioma (MPM) offers some hopeful news for mesothelioma patients.

The article, published in Current Oncology Reports, analyzes an array of mesothelioma treatments, from new and existing chemotherapy drugs and new radiotherapy techniques to advances in immunotherapy and gene therapy.

Chemotherapy

The authors note that, although the chemotherapy combination of cisplatin and pemetrexed continues to be the preferred first-line treatment for mesothelioma, the newer combination of gemcitabine and cisplatin has also proven effective, especially in combination with the surgical procedure called extrapleural pneumonectomy and thoracic radiation. Other studies have also confirmed the value of the gemcitabine/cisplatin combination in Phase 2 clinical trials for inoperable mesothelioma.

Radiation

On the radiotherapy front, two new techniques have been introduced for use as part of a multi-modality approach for mesothelioma. Intensity Modulated Radiation Therapy (IMRT) and proton bean radiotherapy are methods for delivering radiation that effectively targets mesothelioma tumor cells while minimizing damage to surrounding tissue. When fewer healthy cells are damaged, side effects are minimized. Mesothelioma patients who are not substantially weakened by treatment side effects tend to have better outcomes.

Other Therapies

New ways of targeting mesothelioma tumor cells with destructive drugs are also showing promise. Hyperthermic intraoperative chemotherapy is a method for delivering powerful anti-tumor agents directly to the surface of the mesothelium, where mesothelioma starts. A heated drug cocktail is washed through the abdominal cavity during surgery, before the surgical incision is closed. Administering chemotherapy in this way helps to minimize the side effects of chemo for mesothelioma patients.

Immunotherapy and gene therapy work on a cellular level to harness the body’s own immune system to kill mesothelioma cells. By targeting particular protein receptors inside cancer cells, these new drugs have been shown to accelerate natural cell death and slow down or prevent cellular replication.

While all of these therapies hold promise for patients, many are still being tested and mesothelioma remains a diagnostically challenging cancer with a poor prognosis. The authors of the article conclude, “Thus, although there are numerous hopeful treatments for MPM, the benefits of these regimens remain to be proven in a randomized clinical setting.”